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Carlsbad Mental Health under new management -- again

By Stella Davis

sdavis@currentargus.com

Posted:
08/16/2013 08:44:37 AM MDT

Current-Argus file photo
Carlsbad Mental Health, under investigation for allegations of Medicaid fraud, is now being operated by an Arizona firm after the former operator, based in Roswell, fell under similar allegations. (null)

CARLSBAD >> Carlsbad Mental Health is under new management -- again.

The state has contracted with Arizona-based Turquoise Health and Wellness as the transition agency for the Carlsbad facility.

In November, the state appointed Counseling Associates Inc., a Roswell-based mental health provider, to manage the local facility while the New Mexico Attorney General's office investigates alleged Medicaid fraud by Carlsbad Mental Health. Allegations of double billing by Carlsbad Mental Health are at the heart of the Medicaid fraud investigation.

Now, the Roswell mental health provider is among 15 behavioral health providers in the state recently placed under investigation for Medicaid fraud and their Medicaid funding suspended.

The Arizona provider has contracted with the state to also manage the Roswell agency, said Matt Kennicott, New Mexico Human Services Department communications director.

Phil Sisneros, public information officer for the Attorney General's Office, said that Carlsbad Mental Health Center is still an open case and the investigation continues.

The investigation by the state Attorney General's Office against Carlsbad Mental Health was launched in February 2012 after a former employee reported she had been advised by two people at Carlsbad Mental Health to bill Medicaid for psychosocial rehabilitation hours and comprehensive community support services at the same time.

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The employee alleged that she was told to bill Medicaid fraudulently and that she explained to the individuals that billing two Medicaid services at the same time was illegal,

In an affidavit, an employee and investigator with Optimum Health, the company contracted by the state to oversee Medicaid programs, met with the agent from the Attorney General's Office and reported that another employee had contacted her and explained that Carlsbad Mental Health Center was billing for transporting psychosocial rehabilitation clients to and from Carlsbad Mental Health facilities.

In late October, a search warrant was executed at Carlsbad Mental Health by investigators from the Attorney General's Office, with the assistance of the Eddy County Sheriff's Office.

The state contracted with the Roswell mental health provider in November to provide services for Carlsbad Mental Health clients.

After the state removed Carlsbad Mental Health's management team, it launched an audit of other facilities in the state and recently suspended Medicaid payments to 15 providers while it investigates allegations of Medicaid fraud.

Sens. Tom Udall and Martin Heinrich, D-N.M., this week wrote a letter to U.S. Department of Health and Human Services Secretary Kathleen Sebelius thanking her for confirmation that the state is not in jeopardy of losing its Medicaid funding while the state's behavioral health system undergoes transition and Medicaid expands its eligibility this fall.

"We want to thank you for your ongoing involvement to protect the integrity of the process and the needs of beneficiaries," the lawmakers said in their letter to Sebelius. "As your staff has indicated, this is a unique situation involving almost the entire behavioral health system in the state -- 87 percent of services are rendered by the providers from whom the payments have been suspended pending outcome of the investigation -- and will require a unique solution.

They noted the federal Centers for Medicare and Medicaid Services has been in daily contact with the state since June to ensure that appropriate transition plans are in place.

Udall and Heinrich have suggested that CMS officials in Washington should come to New Mexico to conduct a public forum and hear first-hand from local stakeholders within the next two weeks, given the time-sensitivity of the concerns, including reports of disruption to services needed for school-age children prior to the start of the school year.

A call to the clinical director at the former Carlsbad Mental Health facility was not returned. Stella Davis may be reached at (575) 628-5546.